NEWER !! COOLER !! WOW !!!

In my honest and sincere opinion most of these things are driven by marketing and not by solid medical science. It seems to me that even though cosmetic plastic surgery is more consumer driven and not medically required for health it should be based in a solid foundation. Money drives this market as with a Holywood movie and this produces what we may call “Hype”. So surrounding all of these new techniques is a onslaught of Madison Avenue Public Relations and marketing hype.  Medical and surgical breakthroughs should be studied and the results analyzed first not get a quick aproval from the FDA and then loudly marketed.  Unfortunatedly this is not always the case.

Hype Central

In the case of LASER assisted liposuction the marketing hype is very rich. “go back to work the next day” or “less pain” or ‘faster healing”. All of these crys of better newer faster are more appropriate for Tide clothes washing detergent than for a medical procedure. Marketers know that using these key words like “NEWER” Or “IMPROVED” will grab consumer attention so they of course utilize these keywords as much as possible.

Yet what is really behind LASER assisted lipo, smart lipo or any of the other brand names? I have spoken with many of the LASER liposuction advocates and detractors , looked at the results and feel I have a good understanding of the procedures.  Basically a very small cannula , which is a tube has a LASER at the end which produces heat. This “melts” some of the fat which turns it to an oily liquid. This is then sucked out with  the cannula. Rather simple concept really. The same thing was done (sorta)  with ultrasonic liposuction which was the latest greatest thing a few years ago. The problem with this LASER lipo is that the cannula’s so far are very very small. So each practioner tells me in any sizeble area  of fat , they still have to use traditional liposuction. —–HUH@#$%^&* !!!????.

I am not a “hater” but my gosh these pencil thin cannulas cannot take out any appreciable amount of fat. So that is exactly why the LASER lipo doctors have to go over the area with traditional liposuction technique.  Now the advanatage is lost completely as you are still doing traditional liposuction in the area. So what is the purpose of using the LASER lipo? I have heard skin tightening, which may be true in a small area like under the chin but for abddominal or thigh or any  larger area there does not to be any benifit what so ever to my eyes and the cases I have seen. So I conclude that the only advantage of LASER lipo suction in most cases is simply marketing.

Well marketing is potent stuff. If you do not have any patients you cannot do any liposuction,  be it LASER, Ultrasonic or traditional.  So I see the reason why many surgeons like this idea , it is great marketing. Yet for me I have seen these trends come and go and until someone shows me an advantage that I consider worthy,  I will stick to the techniques which I have used for many years with so much success. Maybe I am old fashion, but somehow I cannot stomach doing something just for marketing or 90% marketing. I know Plastic Surgery is suppose to slick and whiz bang,  but again I like the traditional well proven techniques  over marketing . Thats me.

doctor808

The crowd was fun and interested

My staff had put a lot of work into this event and I think it was a success. The most important issue to me was I tried to evaluate something new we call the Aloha Dysport Lift. This is where I inject in the superficial layer of the skin Dysport in a special pattern. For reasons I will not dicuss here the facial skin is lifted to a small degree and lines will dissapear. I will be writing more about this later on a web site we are in the process of building. So for now I will tell you what we did. We did this on three patients from the audience but only on the right side of the face. We then waited 30 minutes. I then under High Density Video we asked the audience to raise their hands if they could see a difference. Amazingly every one raised their hands and all agreed that they could see the changes in each of the three patients. I actually begged them to not to go along with the crowd if they doubted what they saw. Still they all agreed that they could see the changes. This to me was amazing. We will show the pictures on the web site at a later date so stay tuned.

My Staff was available to answer questions

The staff stood by to answer questions. Many good questions came from the audience about Breast Augmentation. Liposuction and all the various fillers such as restylene, juviderm and the like.

The food was great and we really enjoyed this event and learned a lot about the Aloha Dysport Lift.

We hope to have future events such as this and we thank our sponsors.

Doctor 808

Can you guess who this is?

One problem I noticed was the concern to pass the military tape test. This is some diabolical method by which the military member is judged if they are too fat or not ,for the promotion or retention board. It never ceases to amaze me the super fit GI who would come in my office  having  failed his tape test because his neck -waist line ratio was off.  Yet he looked like godzilla and or Mr. America muscle bound. Yet that is the way it goes some time, the tape test has been determined to be fair and the best way. There are also those who just have an abnormal area of too many fat cells which throw the tape off.

Well for those types I am always happy as most times I can change that, really change the results on the next tape test. They get their promotion or pass the standard and everyone is happy! Plastic Surgeon is happy, Military member is happy, Commander is happy and life is good and I am the hero plastic surgeon.  The reason why it works so well,  is that it simply is taking inches off the problem area,  typically its the waist on men, hips on woman and the liposuction does the job. Get rid of those inches. The 25 th infantry here in Honolulu Hawaii I see often enough and some of the Primary Care Docs have sent me their soldiers.  However,  I will not pick on the Army,  the Navy is more often the ones who come in. I guess navy ships food is very good.

Yet I shall not forget the marines, these tough guys are the ones who are most often the most nervous about the procedure. It seems the bigger they are the more nervous they are. Liposuction may make them nervous but the tape test is anxiety can be worse !

Well back to the quiz of who the guy who is loading mortar shells in the picture. Its the same guy who is the picture below on the far left. Yes thats me. I am on the far left of your screen actually the only American as a “military advisor”. I could tell you where but then I would have to ……..you

Doctor808 19 years ago----can you guess where?

doctor808

American Eagle

Today we completed http://www.militaryplasticsurgery.com which is our newest web site creation for Plastic Surgery and Military Members ( yes including military discounts) . Appropriate I would say for the 4th of July!

Military Plastic Surgery Website

Many Americans hardly know anymore why we celebrate the 4th of July. This day in 1776 is thought (although there is some debate) that the Declaration of Independence was made and signed. The story is very interesting, in that the founding fathers of the USA were taking an extreme risk to  discuss such a thought as to gain independence from the British Empire. They easily could have been hung or drawn and quartered for such treasonous act.  We today in the USA forget how much freedom we have now ,to say what we want and to discuss freely ideas. This simply was not possible in 1776.  A person who spoke against the King of England at that time could have paid for his or her words with his or her life. It is unfortunate today we have taken our freedom for granted and there is high risk of  losing that freedom . President Reagen said we are only at any time one generation from losing our freedom.

Our military , the young men and woman who serve to protect that freedom seem to be a group who know well what freedom lost can mean. They have seen it with their own eyes and heard it with their own ears in Afghanistan,. Iraq and elsewhere,  the misery brought on by dictatorship and years of lack of freedom. We need to really look around and see the world as it is, learn history and current events and see what leads to loss of freedom to prevent that from happening here. It can happen and is happening as you read this. The Romans did not notice either,  until it was too late and they lost their republic. It seems a republic ( USA is not a democracy , never was but  a republic) like ours can only last maybe two hundred years…??

I just hope our young people will take the time to really learn something about our history, not just about what is cool or the trend of the day. I do both so can you. You can do cool things and learn history , keep current at the same time.

Plastic Surgeons 4th of July

On the fourth of July, this plastic surgeon does what many Americans will do, that is barbecue outdoors. In fact,  I just finished two of the most juicy hamburgers I have ever known. I cooked them myself on my lanai on a charcoal grill. I dont care for the gas grills which are popular, it just does not taste the same. Also we had pork-n-beans and potato chips with a side of pickles,,,hmmm good.

I don’t eat that way often,  other wise I would need liposuction myself,  but on occasional holiday its fine. Its a sorta of traditional issue on the 4th of July for this plastic surgeon in  Hawaii. I wonder if the military in Afghanistan and Iraq are having hamburgers and hot dogs too?

I think many are and we hope they are safe!

So for any of my readers who follow this blog either for Muay Thai Kickboxing , for Web design or Plastic Surgery in Hawaii—yes its cool,  but lets take a minute and really appreciate what today is. Take a few minutes and look up some facts about Thomas Jefferson, John Adams, Ben Franklin and others who signed that declaration on this day in 1776. It a day that changed  the world.

doctor808

Military Plastic Surgery and Plastic Surgery In Hawaii

Many of you may not known I was in the military for many years. I spent most of time  in the reserves. In fact, I spent a lot of that time with the 20th special forces group which at the time was a reserve unit (NG) and we were based out of Maryland. During my time I met some of the greatest people anyone could meet, dedicated, smart. most spoke at least two languages.

As a plastic surgeon in Hawaii I meet many military members and their families from the marines , the army and navy as well as special operations. I always share with them war stories and understand their military life. It was some of the best experiences I have had. As a Hawaii plastic surgeon we also have patients from Guam, Japan and Korea who are in the American Military. Interesting to note we have many patients who fly back in have their plastic surgery in Hawaii and fly back to their Pacific bases.

I think one of the most interesting time,  was when we received 6 emails from Afghanistan from 6 female soldiers who some how had heard about us. They all flew back at the same time when their tour of duty ended and we performed 6 breast augmentations,  Wow —talk about beautifying the country. In a more serious light my hat goes off to these dedicated individuals who sacrifice for our freedom in some of the most harshest conditions on earth. I think 4th of July coming up is an excellent time to salute them. They are in hearts and minds as they serve heroically.

Our web development company has even devoted a web site specifically to these service members about plastic surgery and we offer a discount. This can be found at www.militaryplasticsurgery.com . This web site about military and plastic surgery will offer discounts and address some of  the issues we have seen. So Please take a look.

doctor808

Plastic Surgeon Dr. Pasquale

The latest buzz on the internet is Smart Lipo, or LASER Assisted Lipo which is a new fangled device where a small cannula is inserted through the skin and utilizes LASER technology to perform liposuction. Now as many of my patients know,  I am not one for “new fangled devices” having been in plastic surgery for twenty years. I have seen everything come and go ( mostly go). Check my web site  www.nerve.org.

As example,  after the silicone breast implant hysteria about  15 years ago they developed “soy oil based breast implants ” which were actually used in England for a while. These new fangled devices were the latest, the greatest newest technology to use on patients as advanced plastic surgery technique. After all the soy (yes from soy beans) was ORGANIC so it must be good right? Well shortly after serveral patients reported the leaking of smelly rancid oil from their breast. How could this be? The latest greatest technology was used and it was NEW so must be better. Well the fact is , this was a poorly conceived idea, brought to you by marketing and latest greatest new fangled plastic surgery technique promoters. My point is simply the newest idea is not always the best idea. I approach all new plastic surgery technology with a very critical eye. Maybe I am jaded after many years of listening to every salesman in the world come in my door and tell me “Doc this will change your practice and you will be ahead of your peers!!!”. Yet for me expierence with a procedure or technology says it all and that is why I don’t jump on very new bandwagon. Salesman and marketing hype says nothing, but does show you someone wants to sell you a new product or technology for good or bad.

So I have some initial impressions I want to share after researching this new fangled procedure of Smart Lipo or any of the “me too” LASER Liposuction techniques. First what is this. Well according to one web site :

“SmartLipo is by far the best kind of liposuction available today. It is a method that offers the best results with less trauma and less downtime. It has a fast recovery time and the cost is very competitive.

SmartLipo uses laser technology to melt and liquefy the fat within the fat cells. In addition, it smoothes and tightens the skin to decrease the looseness that one sometimes sees with traditional liposuction. It can be utilized alone to treat smaller areas of fat, such as below the chin, or in combination with liposuction to remove larger areas of fat such as in the abdomen, flanks and thighs.”

In my analysis of this and knowing what liposuction really is in detail,  I have a few thoughts on this. First any web site that claims that something is the “BEST” as they do, is not medical advice but salesmanship. Plastic surgery be it liposuction or face lifting there is no such thing as “the best”. If there was truly the one and only “best” everyone would use that as plastic surgeons want the best. Its the same as those web sites that claim that transumbilical breast augmentation is the “best” procedure or this plastic surgeon is the “best” etc. To me this automatically tells me something is not right and I should look carefully and recoginze this all as marketing hype. Yes we all want to put our best face forward but come on “the best”.

Next I see a very key statement used: “It can be utilized alone to treat smaller areas of fat, such as below the chin, or in combination with liposuction to remove larger areas of fat such as in the abdomen, flanks and thighs” . Translation is simple, we can use Smart Lipo for very small area but we have to go back to traditional lipo for any area larger than under the chin or combine it.  That says it all. The great benifits they state such as quicker recovery time are nullified when you then have to combine it with traditional liposuction as the surgeon has to o over the same area with a regular liposuction technique. I actually spoke to a Smart lipo practioner recently and asked him as a peer what is the advantage of this then. I mean you take the smart lipo cannula and insert it and then imediately after that insert the traditional device so why in the world would you do that. Well he said “marketing and patients like that”. He then told me that the big advantage was that it does do some skin tightening under the chin in this small area it  can be used without combing it with traditional liposuctio technique.

Well to my way of thinking that seems reasonable under the chin,  but most patients need liposuction that I see in my Hawaii plastic surgery practice other areas such as the abdomen, flanks and thighs. So few patients need that I  cannot see buying an expensive machine to serve one small purpose maybe better. I suppose its a good idea for marketing —so you can say “Hey folks I have the latest greatest new fangled device” but I dont need that in my practice. People know me and know who I am which I try to have a consistent good quality reliable and ethical practice. I suppose if I was new surgeon and needed some gimmick to help my practice , maybe it would be worth it,  but I am not so for me ….its a no go at this point.

The problem with these newer technologies is that they have not been around for years and we really dont know yet all the effects. We do know with all the energy generating  liposuction devices they can burn the skin. Now Smart Lipo may be different, but the ultrasonic techniques ( we have treated complications of  this in the past ) were a energy generating in the form of  heat that could damage the skin and did in some cases. In the case of smart lipo the energy generated producing heat from the LASER is how the skin is tightened.

Patients write about this procedure , the Doctors who promote this procedure create the buzz around the internet. The smart lipo procedure is then a great marketing tool I suppose. Yet call me old fashion. I would have a plastic surgery procedure for result, proven safety and to do what I want it to,  not to have the  have the best marketing  as a consumer. Thats me.  As a doctor on the other hand maybe its good for their practice to be part of this buzz and brig in many patients.

Well these are some of my thoughts on this new fangled procedure. Its not that I am against anything new, its simply that I rather use traditional and proven technology which I have used for years and take a wait and see approach o the new stuff. As with the soy based breast implants, this  prooved to me the latest greatest and newest is not always the best. When something sounds too good to be true it probally is. So bottom line is do your research  and dont be a dumb consumer. Plastic surgery like any business is business which you need to be a smart comsumer with or without smart lipo.

Doctor808

]]> http://doctor808.com/author-dr-pasquale/plastic-surgery-hawaii-smart-lipo-dumb-consumer-an-editorial//feed 0 http://doctor808.com/author-dr-pasquale/a-few-thoughts-about-travel-to-other-countries-for-plastic-surgery/ http://doctor808.com/author-dr-pasquale/a-few-thoughts-about-travel-to-other-countries-for-plastic-surgery/#comments Fri, 24 Apr 2009 08:19:18 +0000 drmap http://doctor808.com/?p=113

Well the recent troubles with Ushers wife going to Brazil and having a cardiac arrest make this a very topical topic. Many people travel to places other than their home towns to have  procedures. Here in Hawaii I have spoken to many patients who come to my office after travel for cosmetic procdures. Some go to Korea, Thailand and other parts of Asia. Recently a woman told me she was going to Mexico to have the procedure we discussed at half the cost. 

Basically there are good plastic surgeons all over the world which is not the problem. You can find good surgeons in Mexico or in any of the other countries I mention no doubt. The problem is when there is some difficulty. Not only are you miles away from family or any support, but the money you would have saved now is lost  and most likely has become so much more than the original cost quoted locally.

What comes to mind was doctor and her husband who went to Brazil to have the LASIk procedure done to correct some vision problem. She and her husband both had the procedure at a substantially reduced cost,  than they would have in the States. Yet she had a problem after surgery which she had to travel to London eventually to correct. As london indeed had the only expert in her problem. Although she saved money with the initial surgery it cost her over 8 times more and she is still receiving treatment.

This story has been repeated many times in my practice a girl who traveled to Thailand who had some rubber unknown sack used as a breast implant which I took out for example. She wasted her money. Even when people have quality plastic surgery done away from home if they have a problem they have to fly back to the place which cost additional money.  It can work but dont think you will save in long run , the numbers do not work out.

I have patients fly in to see me as well. Yet we require them to stay till everything is ok. Even then we tell them that if they are from Japan for example  we may have a doctor they can see there,  but it may require a plane trip back to Hawaii. Its not that I condemn the practice,  but I want to make sure they are appraised of the risk and know that in long run saving money will not be one of the benefits.

Well these are some of my thoughts Summary: You can fly far away to have plastic surgery and it may be good idea if you find the right surgeon. Yet do not think you will save money and you best be able to be prepared if something goes wrong to pay extra. The only reason I can see to take this risk is that you are traveling for special expertise. You pay for that, so going for cheap is not a good reason.

Doctor808

plenty of water during exercise

So many of my patients expect me to change with one operation years of neglect, but it’s not going to happen. As I have learned good exercise and diet can do more than I can. Plastic surgery can help, but a sound foundation of a good lifestyle cannot be beat.

My personal reccomendation is to mix up your program with cardio, resistance training and a stretching such as Yoga. It takes time and discipline but will take years off of you. I kick box muay Thai style 3-5 times a week and weight lift 3-4 times a week.

Diet I keep on the high protein low carb. This keeps my weight down. I actually had some liposuction around my mid line which allowed me get a six pack finally. I could lose the fat around my belly but when I did my face looked hollow. So liposuction did the trick.